Athletes and Eating Disorders

1. Athletes and Eating Disorders

2. Video • www.youtube.com/watch?v=0XzT3AK3Rkg

3. True/False • Eating disorders affect both males and females.

4. True/False • Eating disorders affect both males and females. • True—approximately 5% of females and 1% of males are affected.

5. True/False • Ten percent of people diagnosed with anorexia will die from effects of the disease.

6. True/False • Ten percent of people diagnosed with anorexia will die from effects of the disease. • False—20% of people diagnosed with anorexia will die from the effects of the disease.

7. True/False • Individuals who have anorexia nervosa always eat less than they should and so starve themselves in order to lose weight.

8. True/False • Individuals who have anorexia nervosa always eat less than they should and so starve themselves in order to lose weight. • False--Some anorexics may eat a normal amount of food but may exercise so much that they burn off a majority of the calories they consume.

9. True/False • When considering the criteria for binge eating, females tend to binge eat more than males.

10. True/False • When considering the criteria for binge eating, females tend to binge eat more than males. • True– research has showed that even though males have a higher tendency of binged eating on a weekly or greater basis than females, females tend to feel more out of control when overeating.

11. What is an eating disorder? • Eating disorders are extreme expressions of a range of weight and food issues experienced by both men and women.

12. Types of Eating Disorders • Anorexia Nervosa • Bulimia Nervosa • Other Disorders Otherwise Not Specified • Binge Eating Disorder • Anorexia Athletica

13. Binge Eating Disorder • Recurrent episodes of binge eating • Eating until uncomfortable • Eating large amounts of food when not hungry • Eating alone due to embarrassment • Binge 2 days/week for 6 months minimum

14. Binge Eating Disorder • So what makes this differ from Bulimia Nervosa . . . • Usually not associated with purging, fasting, excessive exercising, or laxative use

15. Anorexia Athletica • Frequently found in athletes • Shows signs of disordered eating and distorted body image • Fails to meet criteria for anorexia nervosa or bulimia

16. Anorexia Athletica • Intense fear of gaining weight or becoming fat even if individual is usually underweight • Restriction of food (<1,200 kcal/day) • Compulsive exercise • Amenorrhea • Occasional bingeing or purging

17. Common Causes of Eating Disorders • Highly Successful in All Endeavors • High Expectations for Self • Parents Set High Expectations for Child • Family Often Exerts Tight Control on Child • Family has Low Tolerance for Conflict

18. Who’s at risk? • Females are twice as likely as males to be at risk for eating disorders • Societal pressures • Biological factors • Physical demands of the sport Sports with high risk factors • Women-cross country, gymnastics, swimming, track and field • Men-wrestling, cross country track

19. Other possible causes • Negative family patterns • Media influence • Cultural factors • Triggers • Traumatic events

20. Disordered Eating • Term is often used interchangeably with eating disorders • Disordered eating has no specific diagnosis • Continuum from normal eating patterns to eating disorders • Disordered eating would fall somewhere on that continuum

21. Disordered Eating

22. What Can CauseDisordered Eating? • Intense Dieting • Desire for Athletic Success • Fear of Failure • Frustration or guilt when not able to control weight and/or appearance • Coach and/or parent comment about athlete’s weight/appearance

23. Athletes and Eating Disorders • Athletes tend to be highly competitive, high-achieving, and self-disciplined, which can lead to the development of an eating disorder when these qualities are taken to the extreme • Athletes in sports emphasizing appearance and a lean body are at higher risk than those in sports requiring muscle mass and bulk • Female athletes at a higher risk due to social pressures and naturally higher percentages of body fat than men • Transition from wanting to lose weight and get fit to a loss of control: binging, purging, starvation, frantic compulsive exercise

24. Athletes and Eating Disorders • Risks of injury are greater among athletes who have an eating disorder—for example, stress fractures • “Female athlete triad” • Disordered eating • Amenorrhea—stopping of menstrual periods • Osteopenia—mild bone loss that can lead to osteoporosis

25. Female Athlete Triad Risk factors • Weight loss • No periods or irregular periods • Fatigue and decreased ability to concentrate • Stress fractures • Muscle injuries

26. Symptoms (FAT) • Continued dieting in spite of weight loss • Preoccupation with food and weight • Frequent trips to the bathroom during and after meals • Using laxatives • Brittle hair or nails • Dental cavities because in girls with bulimia tooth enamel is worn away by frequent vomiting • Sensitivity to cold • Low heart rate and blood pressure • Heart irregularities and chest pain

27. Wrestlers • Cycles of binging and purging to achieve target weight dangerous • Three wrestlers died in the latter part of 1997 from rapid weight loss, which is mostly water weight • Two wore rubber suits while working out in hot rooms • Severe dehydration can cause death from kidney failure, heart malfunction and brain damage

28. Eating Disorders or Disordered Eating? • Convincingly, more athletes do have disordered eating issues • Distorted views on food, eating, weight, and performance • Possible results • Body Dysmorphia Disorder (BDD) • Muscle Dysmorphia

29. Body Dysmorphia Disorder (BDD) • Obsession with a defect in visual appearance, specifically the face, hair, nose, and skin • Treatment has varied results • Some success with obsessive-compulsive disorder drugs • Cognitive behavior therapy may be beneficial

30. Muscle Dysmorphia • Is a form of BDD • Found in athletes who deliberately diet and overtrain • Is an excessive preoccupation with being muscular and fit • Have severely distorted body image • See themselves as small and weak • Possibly abuse steroids and other substances • Depression, low self-esteem, social withdrawal

31. Case study • 695 Male and female athletes • 1/3-preoccupied with food • ¼-binged at least once a week • 15% thought they were overweight when they were not • 12% feared of losing control or actually did lose control when they ate • >5% ate till they were gorged and nauseated • 5½% vomited to feel better after a binge and to control weight • Almost 4% abused laxatives • 12% fasted for twenty-four hours or more after a binge Reference: www.anred.com/ath_intro.html

32. Treatment • Coaches • Teammates • Trusted friends • Websites • National Eating Disorders Association • www.edap.org • www.eating-disorder-refferal.com • www.eating-disorder.com

33. So When Do We Educate? • It is NEVER to early • Over 60% of 8-year old girls are either dissatisfied with their body or have tried to lose weight • This number increased to over 80% by the time a girl becomes 11

34. YOUR Role as a Health Care Professional • Educate athletes about normal food intake • Explain myths about diet, exercise, and health • Evaluate food intake • Work with team officials and medical personnel to document diet and behavior changes

35. Prevention Education

36. Eating Disorder Prevention • Emphasize Individuality • Don’t Focus on Weight/Appearance • Reduce the Competition to be Thin • Eliminate Group Weigh-ins • Eliminate Team Weight Limits • Focus on Overall Fitness • Set Individual Goals • Use Appropriate Guidance for Weight Management

37. Treating Athletes withEating Disorders • Develop a close relationship with athletes, coaching staff and other team officials • Prepare that the athlete may not admit they have a problem • Ensure confidentiality • Never discuss issues with or in the presence of team members • Develop a team approach to treatment • Coach, Medical Staff, Counselor, and Parents

38. Working with Parents • Assume that parents may not be aware of their child’s condition • Understand that the parent(s) may not admit their child has a problem • Realize that a parent’s and/or coach’s comments may have served as a precursor for this condition

39. Crossword Puzzle

40. 1. The absence of menstrual periods.

41. 1. A person possessing the natural or acquired traits, such as strength, agility, and endurance, that are necessary for physical exercise or sports, especially those performed in competitive contexts.

42. 4. An eating disorder

43. 2. A psycho physiological disorder usually occurring in young women that is characterized by an abnormal fear of becoming obese, a distorted self-image, a persistent unwillingness to eat, and severe weight loss. It is often accompanied by self-induced vomiting

44. 5. A period of excessive or uncontrolled indulgence in food or drink

45. 3. Combination of three conditions: disordered eating, amenorrhea, and osteoporosis. A female athlete can have one, two, or all three parts of the triad

46. 7. A group of synthetic hormones that promote the storage of protein and the growth of tissue, sometimes used by athletes to increase muscle size and strength.

47. 6. A regulated selection of foods, as for medical reasons or cosmetic weight loss.

48. 8. A measurement of the relative percentages of fat and muscle mass in the human body, in which weight in kilograms is divided by height in meters and the result used as an index of obesity.

49. 7. Pride in oneself; self-respect.

50. 9. Physical activity that is governed by a set of rules or customs and often engaged in competitively. .